What question did this study set out to answer?

To compare the efficacy and safety of deep anterior lamellar keratoplasty (DALK) against penetrating keratoplasty (PK) in patients with corneal stromal pathologies lacking endothelial abnormalities.

November 18, 2015Cornea

Deep Anterior Lamellar Keratoplasty Versus Penetrating Keratoplasty

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To compare the efficacy and safety of deep anterior lamellar keratoplasty (DALK) against penetrating keratoplasty (PK) in patients with corneal stromal pathologies lacking endothelial abnormalities.
Conducted a meta-analysis searching PubMed, EMBASE, and ClinicalTrials.gov for randomized controlled trials comparing DALK with PK.
Included 5 randomized controlled trials encompassing 409 eyes (217 in the DALK group and 192 in the PK group).
Evaluated visual outcomes (best-corrected and uncorrected visual acuity, refractive error) and safety endpoints (endothelial cell loss, graft rejection, endothelial rejection).
Penetrating keratoplasty achieved superior postoperative LogMAR BCVA (WMD = 0.04, 95% CI, 0.01 to 0.07, P = 0.005) and UCVA (WMD = 0.12, 95% CI, 0.05 to 0.18, P = 0.0007), though the proportion achieving BCVA ≥ 20/40 did not differ significantly (RR = 0.97, 95% CI, 0.89 to 1.07, P = 0.57).
Penetrating keratoplasty resulted in significantly greater endothelial cell loss compared with DALK (WMD = -8.75%, 95% CI, -15.25 to -2.25, P = 0.008).
Deep anterior lamellar keratoplasty demonstrated a significantly lower risk of overall graft rejection (RR = 0.48, 95% CI, 0.28 to 0.82, P = 0.007) and endothelial rejection (RR = 0.07, 95% CI, 0.01 to 0.35, P = 0.001).

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Implication

Meta-analysis reveals deep anterior lamellar keratoplasty yields fewer graft rejections but slightly lower visual acuity than penetrating keratoplasty, indicating trade-offs between safety and...

Cite This Study

Chen et al. (2015) studied this question.

synapsesocial.com/papers/6a8974598371e1a748c98b4e https://doi.org/10.1097/ico.0000000000000691

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Implication

Meta-analysis reveals deep anterior lamellar keratoplasty yields fewer graft rejections but slightly lower visual acuity than penetrating keratoplasty, indicating trade-offs between safety and...

Deep Anterior Lamellar Keratoplasty Versus Penetrating Keratoplasty

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Discussion

Implication

Cite This Study

Deep Anterior Lamellar Keratoplasty Versus Penetrating Keratoplasty

Key Points

Discussion

Implication

Cite This Study